Pelvic physiotherapy is a complex therapy that belongs exclusively to the competence of physiotherapists! The therapy may include manual examination of the muscles of the pelvic floor, targeted movement therapy (conscious function), as well as other physiotherapy methods (soft tissue treatments, manual treatments, trigger point therapy).
Types of pelvic floor dysfunction:
- Difficulties in bladder and/or bowel control (urinary incontinence, faecal incontinence, overactive bladder syndrome – OAB, metabolic problems)
- Sexual dysfunctions – pain or numbness during intercourse
- Chronic pelvic pain
- Pelvic Organ Prolapse (POP)
In each of these disorders, the underlying problems can be caused by over- or under-functioning of the pelvic floor. Overactivity of the pelvic floor (hypertonic disorders) is caused by excessive muscle activity or a decrease in the ability of the muscles to relax. Pelvic floor dysfunction (hypotonic disorders) is caused by weak or shortened muscles.
If there is pelvic floor dysfunction, not only the pelvic floor itself deserves a thorough examination, but also the lumbar spine, hip joints, and the muscle system connected to them (abdominal muscles, lumbar muscles, muscles around the hips).
Pelvic floor muscles (PFM) perform various functions in the human body:
- they support our internal pelvic organs (bladder, uterus, rectum etc.)
- perform the closing function of the sphincters of the urethra and rectum
- in women they participate in the formation of the birth canal and
- perform a sexual function
If the functions are broken, the following symptoms are experienced:
- urgent urge to urinate
- urinary incontinence (urine dripping, peeing) when coughing, sneezing, jumping, running
- painful urination
- urinary retention
- pain around the lower abdomen area, genitals and rectum
- pain around the pelvis, sacrum and coccyx
- painful intercourse / numbness during intercourse
- gastrointestinal disorders (bloating, constipation)
Do men also suffer from pelvic floor dysfunction?
- Men can also suffer from pelvic floor dysfunction. Urinary incontinence is common after pelvic surgeries, such as radical prostatectomy. Sexual pain, gastrointestinal disorders, and coccyx pain due to overactive pelvic floor muscles are also common complaints. In addition, sports that increase pressure in the abdomen and involve high physical activities (running, weight lifting), overloading, unprofessional training and hard physical work can also cause pelvic floor dysfunction.
Risk factors for pelvic floor dysfunction:
- advanced age
- menopause
- female gender
- childbirth
- number and type of births
- obesity
- sedentary lifestyle
- high physical activities, high-impact (race) sports
Are pelvic floor diseases common?
- Yes, just to highlight one of the listed: Urinary incontinence, the involuntary loss of urine, is a common set of symptoms in diseases of the pelvic floor. Not even a drop of involuntary urine loss is considered normal! Nearly half a million people in our country suffer from urinary retention problems! Less than 60% of those affected seek help, due to embarrassment, lack of knowledge about treatment options, or the belief that urinary incontinence is a normal and inevitable process with age.
Do pelvic floor exercises help reduce urinary incontinence?
- Yes, in the case of mild and moderate complaints, training of the pelvic floor muscles is the first-line therapy in the treatment of urinary retention disorders attributable to sphincter muscle weakness.
When is pelvic floor training not recommended?
- inflammation of pelvic organs (bladder, uterus, ovary, prostate)
- acute hemorrhoids
- threatened pregnancy
- in the 1st trimester of pregnancy
- during menstruation
- in case of overflow and reflex incontinence
What can be expected at the health assessment?
- detailed medical history, musculoskeletal questions and questions about the state of the pelvis, similar to the questionnaire on the website
- interpretation of existing medical findings
- in case of need or complaint, manual examination of the strength of the pelvic floor muscles inside the vagina, lying down and standing examination of the symptoms of prolapse – uterine prolapse (descensus uteri), bladder hernia (cystocele) and rectal hernia (rectocele)
- examination of posture in underwear, spine and hip joint movement and muscle strength, muscle tone, examination according to special tests
- setting goals: which forms of exercise, sports, activities you want to return to. In the case of running and other extrem physical activities, we build up the gradual loading according to a defined, strict, scientific, up-to-date protocol, while placing great emphasis on pelvic floor training
- setting up a physiotherapy treatment plan
- discussing and promoting the need for biofeedback therapy (additional device therapy based on feedback on the actual functioning of the pelvic floor muscles) and other additional therapies
- individualized strengthening and stretching exercises
- pelvic floor muscle training, which can focus on strengthening, flexing and relaxing the muscles